Chemotherapy of pancreatic cancer in patients with poor performance

Pancreatic cancer is the seventh most leading cause of all cancer related deaths, accounting for 4.5% of these (1,2). Less than 20 % of the patients who are diagnosed with pancreatic ductal adenocarcinoma present with a nonmetastatic localized disease and surgery is a potential curative option (3). Another third of the patients present with locally advanced nonmetastatic cancer and may undergo neoadjuvant chemotherapy with or without radiation followed by exploration and resection as a possible curative treatment. In most of the cases however, patients are diagnosed with a metastatic disease and chemotherapy is the only viable option to increase overall survival and improve quality of life by relieving symptoms.